Multidisciplinary Care for Rheumatoid Arthritis
(MAPPIT-RA Trial)

Recruiting in Palo Alto (17 mi)

George KARPOUZAS | Professor | Research ...

Overseen byGeorge A Karpouzas, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center

No Placebo Group

Trial Summary

What is the purpose of this trial?This research will evaluate a multifaceted patient-centered intervention in a sample of socioeconomically disadvantaged Hispanic adults with rheumatoid arthritis (RA) that capitalizes on a partnership between the extended rheumatology healthcare team and each patient in order to promote understanding, uptake and adherence to the principles of treat-to-target strategy. The primary hypothesis of this study is that the addition of a multifaceted intervention incorporating integrated multidisciplinary rheumatologic care, nurse-directed self-management education and supportive follow-up, and technology-based at home RA symptom monitoring and reporting to clinical guideline-based care will increase RA remission rate at 6 months.

Eligibility Criteria

This trial is for socioeconomically disadvantaged Hispanic adults in the Greater Los Angeles area with moderate to severe rheumatoid arthritis (RA), as defined by specific clinical scores. Participants must be able to consent, follow the study schedule, and have a phone. Those with other autoimmune conditions, serious joint damage or medical issues that could interfere are excluded.

Inclusion Criteria

Availability of a touch-tone landline or mobile telephone

Of self-identified Hispanic/Latino descent

Be able and willing to provide written informed consent and to adhere to the study visit schedule and other protocol

+3 more

Exclusion Criteria

I have an autoimmune or mixed connective tissue condition.

Known irreversible articular damage, including subluxations, arthrodesis, fusion, or prosthesis

At risk for suicide

+2 more

Participant Groups

The study tests a comprehensive RA treatment approach combining technology-based symptom monitoring at home, multidisciplinary care from healthcare professionals, nurse-led education and regular follow-ups against standard guideline-based care to see if it improves remission rates after 6 months.

2Treatment groups

Experimental Treatment

Active Control

Group I: Intervention ArmExperimental Treatment4 Interventions

In the multifaceted intervention, participants will first receive an educational session with monthly follow-up phone calls from a trained rheumatology nurse. A rheumatoid arthritis educational booklet will also be provided. During regularly scheduled clinic appointments (at baseline, 3 months, 6 months, 9 months, and 12 months), participants will receive multidisciplinary rheumatologic care, including evaluation by a rheumatologist, physical therapist and psychologist. In addition, participants will be scheduled for ad hoc rheumatology appointments if technology-based symptom monitoring and reporting indicates a marked increase in RA disease activity.

Group II: Control ArmActive Control2 Interventions

Participants will receive standard of care treatment from their assigned rheumatologists during routine clinic appointments scheduled quarterly for the 12-month trial duration. Referrals to ancillary services will occur in a standard of care fashion. Participants will additionally receive monthly healthcare coordinator calls and be given the rheumatoid arthritis educational booklet.